Wednesday, April 13, 2005

11:57 PM


PG-13 for language





Flopped in my chair. I check my watch and sigh with irritation. Another long night ahead.

I'm so tired, but I know I'm not going to be able to sleep any time soon. What I wouldn't give right now for a good night's sleep -- a C would do -- that's all, just a good night's sleep with no nightmares. Please, no more nightmares. Seeing Chase looking at me in the hall like that.... the nightmare just follows me, night and day.

I rub my face and reach for the Vicodin. The neuralgia in my leg has been really bad lately, and now I'm getting headaches on top of that. A good night's sleep, that's all I want. I'd love to sleep for hours, for days, for a week or two, but one good night's sleep -- five or six hours without pain; waking up feeling better, stronger, more clear.... I would make sweet, sweet love to Ambu Annie -- and not even the hot new model, but the decrepit old Annie with the raggedy nylon hair and the blank eyes and the face falling off and the cheesy blue running suit -- if it meant I could get five hours of good sleep afterwards.

Well, I'll have my chance at the end of the month. I don't think any of my staff's up for renewal -- I could check their files if I had to -- oh shit, I'm going to have to do an exit interview for Cameron....


Tomorrow. I'll think about it tomorrow....

And suddenly I come to, realizing I've been sitting here thinking about Cameron's exit interview, about Cameron and Foreman and how completely and utterly I've bungled this. I grimace with disgust. Why can't I just turn off my brain at the end of the day like normal people do? Why do I keep thinking about things I don't want to think about? Why can't I just go to sleep?

Back to ACLS. Maybe Cuddy did me a favor. Renewal's going to last the whole day, so that will be a whole day that I don't have to see any -- well, by then, either -- of my staff. I won't have to see Vogler. I won't have to see Cuddy. Unless Vogler sends Cuddy to make sure that I'm really there. But he won't be taking the class. And none of this firing crap to think about, no money, no clinical trials... I can forget about this sword hanging over my head for a day and just think about medicine, about making people better.

There's a drink and a book on the side table. I take a drink and open the book: it's the text for the ACLS course. I start flipping through the pages. They've made major changes to some of the algorithms since I took my first course all those years ago. Some drugs have been dropped, some new ones have been added.

I take another sip and take a long look at the drink, amber in the lamplight. How many codes have I been in over the years? How many patients have I tubed, how many codes have I called? How many of those patients did I actually save?

I start reviewing the first algorithm, but my mind's not in it....








Lido.”

A pause. Lido’s in!” someone called.

“Shock. 360.”

The rhythmic squeak of the bedsprings stopped: fweeeeeeeeee – “Clear!”– ka-chunk....

“Check a pulse and let’s get another rhythm,” I ordered.

I shifted a little on my feet and took a deep breath. For a fraction of a second I was vaguely aware of the two nurses standing at my right elbow – one handing out supplies from the code cart, one carefully recording the times of every med, every intervention. I had the sense that someone was standing behind me, but I didn’t look to see who it was. I was totally absorbed in the battlefield before me.

Time stopped as I took it all in. Our patient, sprawled pallid and limp on the bed, a CPR board under his shoulders and chest. Patel, standing to the patient’s left, holding the defibrillator paddles; the floor nurses, standing ready with suction and supplies, quickly gathering up med boxes and trash during the lull; Kopp, the med student, ventilating the patient with an Ambu bag; another med student, waiting for orders; my fellow residents, standing at the side of the bed – Sachs holding the IV tubing where she’d been pushing meds, Lee standing at the patient’s bedside, catching his breath after doing compressions, his fingertips to the patient’s carotid artery; all of us, in that long, long moment, with our eyes fixed on the monitor….

Patel spoke sharply. We’ve got a rhythm! Sinus brady.”

“We’ve got a pulse!” Lee replied. The entire room seemed to exhale.

“Well, let’s get a pressure before we break out the champagne,” I snapped.

The pressure wasn’t great; I gave a couple of more orders to treat the bradycardia and correct the patient’s acid-base balance; but we’d done it. We’d saved the guy. I looked to make sure he was keeping his rhythm and turned to see if Van Horn, my R-3, had an ICU bed for us – and took a step back with surprise: Dr Ball himself was standing there.

“Dr. House! The MICU’s got bay 4 ready and waiting for you,” he said.

“Thanks,” I finally said.

In a few more minutes we had the wagon train going, rolling the patient’s bed down the hall, white coats fluttering, Kopp scuttling along as he bagged the patient. I was helping move the bed; I could hear Dr Ball walking behind us, murmuring to the patient’s wife.

We delivered the guy to his new room. I stepped out as the nurses swarmed in and went off with Dr Ball to give my report to the intensivist. When he was satisfied, we headed out of the MICU. Dr Ball walked ahead, but I hung back a little, taking a quick peek into the patient’s room. He looked awful, but he was alive. I tried to not look at his wife.

It wasn’t until I approached the double doors of the ICU that the fatigue hit me. I slapped the wall button and the doors yawned open. I trudged out to find Dr Ball and all the rest of the team waiting outside the unit.

“Dr House! There you are,” he said. “I was just commenting to your colleagues on how proud -- how extremely proud -- I am of the way this entire team handled this code and saved this patient. Extremely proud. A most fitting way to crown these eight weeks we’ve been working together.”

Murmurs of embarrassed thanks went round the circle. He looked us over. Wilted, disheveled… we must have looked pretty rough – it had been a difficult code, and a grueling week.

“I’m in the mood for… some camaraderie. And hash browns, and bacon and eggs. Who’s up for pancakes?” he asked.

We started perking up in a hurry.

He looked pointedly at Patel. “It’s been a long week. Bring Mrs. Patel, if she’d care to join us. And that goes for the rest of you and your… significant others. Who’s coming?” He did a quick nose count. “We’ll meet at the restaurant.” I joined the other residents for our trudge back to our little burrow, and Dr Ball turned and started off down the hall towards his office. On his way, he passed Kopp, who was talking on a hall phone. “You too, Mr. Kopp,” we heard him say. “Join us at Denny’s, and do bring that girl you’re talking to.” Even from halfway down the hall, it wasn’t too difficult to see Kopp’s astonishment. We snickered and headed back to our office to get our jackets.

Since I was, at the time, unencumbered by a significant other, I was one of the first to arrive at the restaurant. It was a damp, chilly March evening. I hung back for a quick smoke. As I sat in my car, I watched the others trickling in. Across the parking lot, I saw Dr Ball’s car pulling in. I stubbed out my cigarette and went inside.

They were already pulling tables together for us. “How many again?” the hostess asked.

Lee started counting on his fingers: “Me, you, Van Horn, Sachs, she said Brian’s coming… What about the Patels?”

“I’ll go ask,” I said. I went back out to the entry. “Hey, Patel. Your old lady coming?”

He turned from the window and gave me an annoyed look. “Yes, yes, I’m just waiting for her.” He turned back and opened the door for Dr Ball.

“What a night! How’s our table coming along?”

“They’re setting it up,” I said. “Lee sent me out for a census.”

“Is Dr Sachs’s friend coming? Yes? So let’s see, that’s five residents plus two, that’s seven, plus one attending makes eight –“ He stepped to the side as Patel opened the door for his wife. “Mrs. Patel, so glad you could join us on such short notice. It will be Dr Patel soon, won’t it?”

She smiled and nodded. Patel took her coat and escorted her in.

“Two students make ten, and…” he looked outside. “Ah!”

I looked out the window, following his gaze. Kopp had just parked his car, and he had a passenger. “It looks like Mr Kopp brought his friend. So two students plus one friend makes eleven. Excellent.”

Sachs came out to wait for her boyfriend and I decided to seize the moment. “I’ll meet you inside, Dr Ball,” I said. He nodded, and I went inside to meet the waitress.

“Eleven,” I said. “And we’ll need a kid’s menu.”

“Crayons?”

“Oh yes!”

“Booster seat?”

That would be pushing it. “Just the crayons. Thanks.” I followed her to the table.

There were four seats left, at the end of the table. I sat down, glanced over to the entrance, and casually put down the menu and crayons.

And here they came. Kopp came in with Eileen, gave her a quick kiss, dropped her off at the table, and made a beeline for the men’s room.

She hesitated for a moment, watching him go. As she turned to sit down, I pushed the menu to the empty place at the end of the table. She looked down at the menu, followed my hand and arm, and looked up to meet my eyes. Her own eyes narrowed.

“I’m sorry, there must be a mistake. I believe these are yours,” she said. She pushed the menu and crayons back across the table and sat down.

I gave her my best wounded look and shook out the crayons. The menu was a paper place mat, brightly colored on the front. I flipped it over – the back was perfect for coloring. I thought for a moment, selected a purple crayon, and drew a little scaffold with six dashes under it. I turned the paper around and pushed it across the table to Eileen.

She rolled her eyes. “E,” she guessed.

I raised my eyebrows ruefully and filled in three E’s:

E _ _ E E _

Oh please, her look said. She snatched the crayon away and filled in the rest of the puzzle: EILEEN. She bent over the paper, writing, and turned it around, presenting the scaffold and eleven new blanks under it.

“E,” I guessed.

She drew a little head on the scaffold.

Uh-oh. Well, at least that ruled out GREGORY HOUSE – but that had twelve letters anyway. Ugh, I needed some coffee.

“T.”

She wrote a T in the third blank.

“I” was a hit twice, including third from the end, and that made N and G easy.

_ _ T _ _ N I _ I N G

“S” only added a body to my little effigy. I did better with “O” and then “R:”

_ _ T R O N I _ I N G

I put on the best “wounded” face I could as I filled in the rest:

PATRONIZING

Eileen wore her haughty face, but her eyes were dancing. I drew a new scaffold with seven blanks. She got E right away, but I had to draw a little head for S. “I” was a hit, T was not:

_ _ _ _ I _ E

One “O,” no “S.” Eileen-in-effigy was up to an arm and the puzzle was not half solved:

_ O _ _ I _ E

“R,” she guessed.

I wrote in the letter. She smiled as she took the crayon and solved it:

FORGIVE

She drew another scaffold and blanks for four letters. I guessed E, S, T, and A and got nothing but a hanging man with two legs.

“I.”

She drew the right arm.

“O.”

Two hits:

_ O _ O

I stared. “T.”

“You guessed that one already.”

“D.”

She drew the last arm on the little man and smirked a little as she filled in the word: POCO. A musical term for “a little.”

I put on a shocked face. “Not fair! That isn’t even English.”

She gave me the haughty face again. “It’s part of the international language of music. Besides, this isn’t Scrabble.”

I reached for the paper. She folded it in half, clean side up, as she passed it back to me. I started to draw; as I started to draw the blanks for the word, Kopp came around the table and sat down.

“Sorry.” He sat down. “What’s going on?”

“Just passing the time,” I said. I pushed the paper across. Thirteen letters.

They’d gotten an E, a couple of Rs, an A, and a couple of body parts when Sachs and her guy finally showed up. They dropped into their seats; Dr Ball was working his way up the table – uh oh. I’d forgotten the only empty seat was next to me.

“Dr House, Mr Kopp…?”

I shot a furious look at Kopp: Get up and introduce her, you dolt.

He took the hint and stood up. “Dr Ball, this is my, um, girlfriend, Eileen.”

Dr Ball extended his hand. “It’s a great pleasure to meet you, Miss…”

She looked a little surprised, but kept her poise as she shook his hand. “Abney. Eileen Abney.”

“I’m so glad you could join us.” He looked down the table; the other residents were all clustered at the other end and were deep in conversation. Sachs was making gaga noises over Patel’s wife like she’d never seen a pregnant woman before. “Miss Abney, that noisy bunch down there is the rest of my team.” He quickly ran down the names -- Kopp’s classmate, the Patels, Van Horn, and back up the table to Lee, Sachs and her squeeze Brian…

“…and Dr Gregory House,” he finished.

I couldn’t resist, and stood to shake her hand. “Delighted to meet you, Miss Abney.” She gave me a regal smile as I sat down.

Dr Ball took his seat at the head of the table. As he pulled in his chair, he noticed the placemat. “It looks like my introductions were redundant. What’s this morbid little game you’re playing? It looks like Wheel of Fortune, French Revolution style.”

“It’s a teaching game,” I said.

He watched as Eileen guessed “I” and I filled in two blanks. Kopp got a “D:”

_ A R D I _ _ E R _ I _ _

Kopp stared at the puzzle. “Cardioversion,” he guessed. I reluctantly filled in the remaining letters. Eileen shot me a triumphant look.

Dr Ball was watching intently. “May I have a turn at this… teaching game?”

“Sure.” Surprised, I passed him the paper and a crayon.

The waitress came around taking drink orders; coffee all around. Patel’s wife ordered decaf; so did Eileen. I made a mental note to ask her if she, too, was pregnant.

“This one’s for you, Dr House,” said Dr Ball. He showed me the puzzle.

“Dr Ball, this is three words.”

He raised his eyebrows. “Shouldn’t the master surpass the pupil?”

“E,” I said quickly.

He wrote in one E.

“R.”

He looked regretful as he drew a head.

A few more guesses, and I was able to solve the puzzle. It was a pet phrase of Dr Ball’s, so it wasn’t too difficult:

AGE QUOD AGIS

Dr Ball said it a lot when talking about confusing clinical situations or doing procedures. The literal meaning is “Do what you’re doing” in the sense of “Pay attention, don’t get distracted,” or, when Dr Ball was getting sharp, “Mind your business.”

He glanced across the table. Kopp looked a little disappointed that he couldn’t leave the maxim at the hospital; Eileen looked intrigued. She obviously knew what it meant.

“You, of all people, should know that phrase, Dr House,” he said. He smiled, but his eyes were serious.

“Who’s next?” I said.

“It would seem that Miss Abney and Mr Kopp here would be next,” Dr Ball said, turning in their direction. “But I’d like to put this game aside for a little while, if you don’t mind. Doesn’t it seem wrong to you to be drawing a gallows for our guest, even if it’s only a stick figure? A noose around her neck? How distasteful. The only thing that belongs around your neck, Miss Abney” – he looked at her necklace – “is jewelry. And you are wearing a very beautiful piece of jewelry tonight. Is it a locket?”

“Not really.” It was a round gold pendant, about two and a half inches in diameter, on a long chain. Eileen turned it over to reveal a watch.

“How beautiful. And unusual. Will you show it to me?”

Eileen nodded, and ran her hands up the chain to the back of her neck. She fumbled for a bit and finally undid the clasp. Dr Ball carefully took the pendant in his hand and examined it closely. I thought about alerting the rest of the team – hey, look, he’s going to do it again! -- but they were yammering about basketball, so I ignored them and sat forward eagerly.

Dr Ball was peering at the watch. “Very beautiful indeed. A remembrance from an aunt, a grandmother? Perhaps your grandfather’s sister? On your father’s side?”

“Yes,” she said, a little nervously. “My grandfather’s sister.”

His face grew concerned. “An inheritance?”

She nodded. “She died this winter.”

His expression was sympathetic, and sincere. “I’m very sorry.” He turned the watch over. “Tell me about your aunt… Catherine?”

I smiled to myself as Eileen gave him a how-did-you-know-that? look.

“I’m guessing she did not have children. Did she work in an office? Perhaps for the government?”

“Yes. She worked in Washington.”

“Did she retire there, or did she come back to your family’s area?”

“She stayed in Washington. She liked it there.”

He smiled. “Did she ever take you to the Kennedy Center?”

“Once,” Eileen said. “We went to another concert hall a lot; she always knew about free concerts that were being held there, mostly the military bands and choruses.”

“Ah, so she had connections.” He smiled. “Now, this watch was a gift from her aunt Catherine before her?”

Eileen stared. “Yes it was.”

“Your family is rich in maiden aunts, I see. Intelligent ones, too. This is reaching way back, I suppose, but do you know anything about your first Aunt Catherine? Perhaps you’ve seen a photograph? I feel a special connection to her; I see she was a nurse.”

“I know she was a nurse her whole life. I don’t know much else,” Eileen slowly said.

“That would be interesting to look up,” Dr Ball mused. “I’d bet she was a Director of Nursing, or close to it, when she retired.” He gently turned the watch over and returned it to Eileen. “Very beautiful. What a treasure you have there.”

She looked down at the watch for a moment before she slowly brought the clasp to the back of her neck. “Thank you,” she murmured.

I could barely hear Kopp murmuring in her ear: “See? I told you, he knows everything.”

The waitress appeared, plunking down cups of coffee. Dr Ball picked up his menu. “We’d better think up something to order.” He flipped through his menu and set it down again.

The waitress finished handing out coffee and came back up to the head of the table. “The usual, Dr Ball?”

“Yes, thank you. Miss Abney?”

She wasn’t ready, so I went ahead (chocolate-chip pancakes with eggs, hash browns, and bacon, extra-crispy.) Around the table; Patel’s wife took a while to decide, so by the time Kopp ordered his burger and fries, Eileen had had plenty of time to decide on a side order of hash browns (she’d already had dinner.)

She stared into her coffee for a moment and looked up. “Dr Ball?” She fingered the watch. “How did you know all that?”

He smiled. “Only the usual way: a combination of observation, experience, and intuition. The size and weight of your watch, and the engraving, show that it was made as a woman’s piece, and the style gave me a hint as to when it was made.

“Now, for the specifics: the monogram on the watch is C.M.A. Unless your mother’s family name also began with an “A,” the monogram probably was for a woman whose last name was Abney. It could have been your grandmother, after she’d been married, but the style of the lettering seemed too old for that, and generally people don’t monogram inherited jewelry. So that’s why I thought that the watch was likely handed down through your father’s family and came to you through a woman on your father’s side, probably an aunt. Now, if this aunt had had children of her own, she probably would have given it to one of them, so that’s why I guessed that the aunt who passed this on to you did not.

“The office work. Look here on the back of the watch. It’s very faint, but do you see how the watch is a little bit scratched, like a belt across its middle? And do you see how, if you lean far forward, the watch knocks against the table? That made me think that the watch was worn for years by someone who worked at a desk. She was proud of her watch, she wore it every day. It may have even been useful to her; perhaps her job involved timestamps. The government job was another guess. The government expanded greatly during the war – lots of jobs for civilians, including single women who wanted something new. Your grandmother’s sister might have been just the right age.

“Now, how did the watch come to her? As I said, the style of the lettering and the age of the watch suggest to me that she was not its original owner. Now, look at this curious little ornament at the bottom of the watch. Right now you’re wearing the watch so that noon points to your face. But that’s just an option. This watch was designed so it could be worn upside down, so that the wearer could just look down and see the clock face. The watch also has a second hand. This is a nurse’s watch.

“Let’s look at the engraving again. Look here -- it’s a little scuffed, but you can just see it – it’s an engraved outline of a lamp, like Aladdin’s lamp, here under the initials, and a Maltese cross. Those are traditional symbols of nursing: Florence Nightingale was the Lady with the Lamp.”

“So, a nurse’s watch, but a beautiful, decorative, engraved one. It looks like some kind of commemorative gift – I was thinking retirement. A date would have been helpful, but the watch is too small.

“Now, assuming this was a retirement gift… At that time, it was unusual for women to spend their whole lives in nursing; they usually quit when they got married, so most senior nurses were unmarried women. And the monogram shows that her last name was an A. Ergo, this distinguished nurse was probably an unmarried woman in the Abney clan. She passed the watch on to her niece, who added a chain and wore it as a necklace, turning it around so that the back of the watch bumped against her desk and not the watch face, and that niece passed it on… to you.

“The Catherine part? Nurse Abney’s name started with a C, and I didn’t think it was going to be something like Cindy or Cheryl. Catherine seemed to be a good guess. And it would make sense that she might pass the watch on to a niece who had been named after her, so that was another good guess.

“So, Miss Abney, how do you come to possess the watch? Do you just happen to be named Catherine? Or was there some closer tie between you and your aunt? Were you and she especially close? Perhaps… a mutual love a love of music?”

She smiled shyly. “A little of both. Catherine is my middle name, but my aunt and I were close. How did you know about the music?”

“Besides the state opera button on your backpack? Perhaps that large folder you’ve got stuck in there, the one that’s about the same size as a music portfolio. Are you a music student?”

“Yes, I’m studying voice at the university.”

“Ah! And what part do you sing?”

“I’m an alto….”

Dr Ball quickly had her telling him all about her studies, about the department, about what ensembles she was in (a choir and two small groups), did she like opera (yes), were we going to see her name in lights someday (unlikely), her impressions of the university and of student life, how she’d met Mr Kopp (a local student hangout), when they’d met (October)….

I glanced over at Kopp, but he’d turned to his right and started talking about computers with his classmate. The other residents were talking about the election or something dull like that. Eileen and Dr Ball were much more interesting; he’d coaxed her out of her initial shyness and now she was happily telling him all about madrigals. I didn’t know much about madrigals and was too hungry to make anything up, so I was content to listen.

The food came, and the table fell silent as we tore into our dinners. I tucked into my chocolate chip pancakes and felt almost giddy when the glucose started to hit my brain.

Finally we started to get our faces out of our plates and act like human beings again. The waitress came around and refreshed the coffee; Dr Ball excused himself, took his cup, and went to work the other end of the table. My fellow residents were deep in conversation with him, and I found myself the odd man out at the end of the table. It didn’t bother me. That’s the way these things usually ended up. I usually passed the time either tormenting dullard med students or ignoring them entirely while I pursued my own thoughts.

But for some reason, I wasn’t in the mood for either of the usual options tonight. Tonight there was a little green-eyed diva sitting across the table from me and… and I wanted to talk to her. That was all. But I was so tired, and –

And she was talking to Kopp. And the other scut monkey. They had their heads together and it looked like they were talking about something at the school, or about people they knew, or their plans for the weekend.

I looked over at the abandoned menu with the crayoned hangman game. Maybe offering another puzzle? No, that joke was over.

I thought about asking her about her classes, but that seemed a little too… pushy, somehow. Especially with her stupid boyfriend sitting right there. I didn’t care about Kopp, but I didn’t want to offend her. Maybe ask her more about madrigals? Too forced. I couldn’t tease her about that afternoon in the practice room any more than I could ask her to send me more marshmallow hearts. I had to pretend that this was the first time we’d ever met. Which left me nothing but… small talk. Ugh.

And it didn’t matter, because she was still talking to Kopp and the other guy anyway, Kopp had his arm draped over the back of her chair, and I had no interest in butting into that little chat. I started twirling one of the crayons between my fingers, suddenly annoyed beyond all reason that we weren’t at a bar or in a smoking section. I started drawing on the other paper placemat – not so much drawing as doodling, as scribbling, as shoving the crayon against the paper, leaving broad wax gouges in its wake.

Suddenly the crayon snapped in my hand. I realized I’d been thinking about the code – why? How useless. I threw down the broken halves in disgust.

“Hey. No throwing crayons.”

I looked up. Eileen was speaking to me.

I felt a smile pulling at the corner of my mouth. I looked around, found an empty sugar packet, wadded it up, and flicked it across the table with my fingernail. She rolled her eyes as she caught it under her palm.

She raised her voice a little. “So, Dr House, do you play golf too?”

Kopp and the other guy looked aghast, and Kopp gave her a pleading what-are-you-doing?! look.

“Why, Miss Abney,” I said carefully. “I’m a doctor, aren’t I? Of course I play golf. But I don’t play very much at all these days. I’ve actually been banned from most of the courses around here because…” I dropped my voice a little. “…well, it’s a sad thing, but, for example, the last time I was at this one course, a sports reporter saw me and followed me all around trying to take my picture, and it got really annoying, and this scout from the PGA got so distracted that he drove a cart into a water trap. And then another time, the manager came over and asked me right there, on the spot, to come on staff, and his staff pros… they got a little upset. And then it came out that I was trying to throw the game because I was there with one of the attendings and was trying to let him win, and the staff pros just fell apart. One of them was crying and broke his clubs over his knee. It was a sad scene. I had to turn the manager down, because, you know, medicine is just my life, and those pros he was going to fire? They had families! I couldn’t just yank the bread out of their kids’ mouths like that.”

I glanced over at the scut monkeys; they looked suitably disgusted. Eileen’s mouth was twitching. “How selfless of you,” she said.

A voice from my left: Brian, Sachs’s guy. “Hey, you guys talking about golf? You know that city course is going to open up again later this month, right?”

Two pairs of scut monkey eyes lit up, one scut monkey mouth exclaimed, “No way!” and two scut monkeys practically climbed onto the table to hear more about the possibility of cheap golf.

I turned back to Eileen. She smiled and leaned forward. “At last,” she whispered. “This golf as religion thing… but do you really play?”

I chuckled. “I own a set of clubs…. I’ll go if I have to, and when I’m home I’ll go with my dad, but it’s not my first choice. Golf’s a bit slow for me.”

“Dave wants to get me into it,” she said. “I keep trying to explain that my brothers already tried but he… I guess he’s just hopeful.” She laughed softly. “So are you into other sports?”

“I used to be in a rec lacrosse league, but it’s just the time thing…. I missed a lot of practice last year so I didn’t sign up this spring. I run, grab a workout when I can. How about you?”

“I’m not big into sports, myself.”

“Too much time in the practice room?”

“Oh, you know how it is… I have to spend a lot of time standing guard over my practice room to keep people from stealing it. If I didn’t have to do that, maybe I’d have more time for other things.”

I shook my head in sympathy. “It’s a wicked, wicked world. So what are you working on, as you toil away in your practice room?”

She raised her eyebrows. “I already talked about my work, Dr House. Now it’s your turn. You have to tell me about yours.”

“You want me to talk shop?”

“No, I want you to tell me more about your work.” She looked over, saw the abandoned hangman game, and drew it over. “Tell me about… cardioversion.”

“What if I don’t want to talk about cardioversion?”

“What do you do when you’re not out there cardioversioning? Do you… play a musical instrument or something like that?” She gave a sly smile.

“Cardioversion. Well, it’s a procedure to get the heart back into a normal rhythm. The heart is beating too quickly and ineffectively, so you apply an electric shock to try to get the heart back into a normal rhythm.”

“Is that what they do with those, um, paddle things?”

“You do cardioversion with the paddles, but when you see those things on TV it’s usually for something different, and it’s a much bigger shock… here…”

Eileen looked genuinely interested, so I grabbed the blank menu and one of the surviving crayons and started drawing a little sketch of little EKG strips, then a little sketch of the heart, and then a bit about the different factors that could cause a patient to crash…

Eileen knew nothing about any of this, but she was attentive and reasonably bright, and much more fun to teach than the average medical student. The waitress refilled the coffee as I kept drawing. One topic led to another; I was deep into a diagram of the liver and the portal vein and a long explanation of oncotic pressure and fluid shifts when I suddenly became conscious of someone sitting at my right. I looked up. It was Dr Ball.

“Oh, keep going,” he said. “You’re doing a fine job here.”

But the spell was broken. I sat up and looked around. The waitress had taken up the plates (except Patel’s, whose wife was finishing up his pancakes for him.)

Eileen was staring at the diagrams. “This is so complicated,” she whispered.

“Yes, it is. Does it make sense?” Dr Ball asked.

“It did when he was explaining it to me.”

Dr Ball pulled over the placemat and crayons and drew the EKG of a single normal heartbeat. “Do you remember what’s happening when?”

She pressed her lips together as she thought, and then pointed with a crayon. “That little bump’s the top half of the heart squeezing, and the big thing is the bottom half squeezing, and that third bump is the bottom half recovering.”

“Very good! As much as he hates to admit it, Dr House is a very good teacher, isn’t he?” Eileen gave me a pleased smile. The waitress appeared and gave the check to Dr Ball. He opened the folder and started checking the bill and calculating the tip. We all started reaching into our pockets for our wallets; he didn’t even look up as he ordered us to put our money away.

He handed the folder to the waitress, glanced at his watch and turned back to Eileen. “It’s a pity we can’t stay longer, or I would ask you to take a turn and instruct us all in the Circle of Fifths.” He stood up and shook Eileen’s hand. “Miss Abney, it has been such a pleasure meeting you this evening. Tell me, is there any chance we’ll ever be able to hear you sing?”

“Actually, yes!” She stood up and started digging in her backpack. “There’s going to be a concert next month” – she produced a stack of pale green flyers – “and you are all invited….”

Dr Ball raised his eyebrows as he scanned the flyer. “Yes, yes, but are you singing in this concert?”

“Yes, I’m in the main chorus, and I’ll also be in some of the smaller groups. And I might have a solo! That part of the program hasn’t been decided yet.”

“Very good! I see it’s at the end of April. I shall have to take Mrs Ball.” He nodded with satisfaction as he folded the flyer and put it in his pocket. “Would you pass some more around the table? And if you have any extras, I can give some to my colleagues -- and to my residents on next month’s rotation….”

She obeyed, handing off a few to Kopp to pass down and giving a few more to Dr Ball. And then she was holding one out to me. “There will be madrigals, Dr House.” I took the flyer, smiled, and tucked it into my pocket.

And then suddenly everyone was leaving. Dr Ball donned his overcoat and stepped ahead to lead the way out. Eileen had her coat on and was putting on her backpack. She looked me straight in the eye – “Good night” – a quick smile, and then Kopp gently laid his hand on her shoulder as they turned to go.

Suddenly I was the last one at the table. As I zipped my jacket, I noticed the abandoned hangman game. Before I knew what I was doing, I picked it up and slipped it into my pocket with the concert flyer.

I was in the last group to leave, with Lee and a couple of the others. We said good-night to Dr Ball, and I had just turned towards the exit, when I heard Dr Ball say, in a low, firm voice, “Dr House. A moment, if you please.”

5 Comments:

Anonymous lunagrrl74@yahoo.com said...

Wow, that was excellent. You have House's voice down!

April 14, 2005 1:02 PM  
Blogger Sanlin said...

Now, sleeplessness and insomnia are areas I *definitely* hear ya on, Doc. You might say I'm a *specialist.* ;-) I'm not known as the 'Night Owl' for nothing. *hoots with sad, but knowledgeable, laughter* If it wasn't for *naps,* I'd be done for... I don't usually get sufficient, deep or restful enough sleep to worry about nightmares, anymore--I'm just unconscious for a few hours. Frequently, chronic pain wakes me a couple of times a night (if I'm not already still up from the insomnia). If I could send you sweet dreams and restful sleep, Doc, I surely would, not to mention an end to all nightmares.

Since you're not talking/thinking about a certain Duckling, tonight, I won't, either... I think you've had enough to cope with, for one revolution around the planet.

I like Dr. Ball. I like the menu drawn on in crayon, too, and I know where that particular treasure still resides. It's funny what we value and what we hold onto, isn't it, when we let so many *important* things slip through our fingers... And we seldom realize, at the time, what will become our madrigals, our key moments, that our brains repeat, over and over, like theme music for our lives... There are so many things we can't shut down or shut off--they're always just beneath the surface, waiting to rise, again.

Wishing you chocolate covered marshmallow bunnies (never mind how I know, I have my sources ;-) ) and a sleep that is full of light, peace and rest, instead of pain. And, if all else fails, know that there's another watchful soul awake, keeping an eye on those who sleep and dream.

Sanlin

April 14, 2005 11:04 PM  
Anonymous Baylink said...

"lunagrrl"?

Do I know you from fanfic somewhere?
-- j

April 17, 2005 12:20 AM  
Anonymous lunagrrl74@yahoo.com said...

Baylink,
It's possible, I've been lurking for years and posted now and then.
:)

This is a great piece of writing. Dr. Ball : Dr. House without the infarction and a little smoothing of roughened edges? I'm not sure, but I do like him.
More, please.

April 20, 2005 2:20 AM  
Anonymous Auditrix said...

Thanks, luna! You did see part 2 of this chapter, right?

a favor for Dr. Ball

and yes, we'll be hearing more about Dr Ball, I promise....

April 20, 2005 2:28 PM  

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